Analysis of perioperative complications and related risk factors of thoracotomy and complete video-assisted thoracoscopic surgery lobectomy

Hongwei Su; Guorong Yan; Zijian Li; Lin Fu; Lingdi Li

Analysis of perioperative complications and related risk factors of thoracotomy and complete video-assisted thoracoscopic surgery lobectomy

Am J Transl Res. 2022 Apr 15;14(4):2393-2401. eCollection 2022.

Authors

Hongwei Su¹, Guorong Yan¹, Zijian Li¹, Lin Fu², Lingdi Li²

Affiliations

¹ Thoracic Department II, Hebei Chest Hospital Shijiazhuang, Hebei, China.
² Department of Orthopedics, Hebei Chest Hospital Shijiazhuang, Hebei, China.

PMID: 35559392
PMCID: PMC9091098

Abstract

Objective: To evaluate the perioperative complications and related risk factors of thoracotomy and complete video-assisted thoracoscopic surgery (c-VATS) lobectomy.

Methods: A total of 93 patients with early lung cancer (LC) treated in our hospital from Mar. 2017 to Mar. 2021 were retrospectively enrolled. Among them, 45 patients underwent conventional thoracotomy lobectomy was classified as the control group (Con group, n=45) and other 48 patients underwent c-VATS lobectomy was classified as the observation group (Obs group, n=48). Surgical indicators of the two groups were compared, and the changes of Visual Analog Scale (VAS) score, plasma levels of vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6), and pulmonary function indexes were compared before and after operation. Additionally, postoperative complications were compared between the two groups. Multivariate logistic regression was carried out to analyse the independent risk factors for postoperative complications.

Results: The Obs group showed significantly less intraoperative blood loss than the Con group and experienced significantly shorter operation time than the Con group (both P<0.001). The Obs group had significantly lower VAS scores than the Con group at 1 day and 7 days after surgery (P<0.05), and showed significantly lower levels of plasma IL-6 and VEGF than the Con group (both P<0.001). In addition, higher forced vital capacity (FVC) and maximum ventilation per minute (MVV) were found in the Obs group than in the Con group (P<0.001), and the Obs group showed a significantly lower incidence of postoperative complications than the Con group (P<0.05). Multivariate logistic regression analysis revealed that age, body mass index (BMI) and operation mode were independent risk factors for postoperative complications.

Conclusion: Compared with conventional thoracotomy, c-VATS lobectomy brings a lower incidence of postoperative complications, and age, BMI and operation mode were independent risk factors for postoperative complications.

Keywords: Thoracotomy lobectomy; complete video-assisted thoracoscopic surgery lobectomy; complications; risk factors.